摘要
目的探讨海水浸泡胸部开放伤的治疗方法。方法 53例海水浸泡胸部开放伤患者采用海水浸泡伤综合方法治疗,包括抗休克,手术,纠正高渗、高钠、高氯血症,纠正酸中毒,抗感染,复温,己酮可可碱(pentoxifylline,PTX)等治疗。检测动脉血气、血浆渗透压、电解质,观察疗效,对治疗前后各监测指标进行比较。结果治疗前表现为低温、血浆渗透压升高、高钠、高氯血症、代谢性酸中毒,治疗4 h后pH值、二氧化碳分压、氧分压、血浆渗透压接近正常,8 h后达到正常水平,存活率96%(51/53)。治疗后各项监测指标与治疗前比较差异有统计学意义(P<0.01)。结论 PTX能够抑制肿瘤坏死因子(tumornecrosis factor-α,TNF-α)的产生,降低肺微血管通透性,对海水浸泡胸部开放伤后致急性肺损伤有一定的保护作用。综合治疗对胸部开放伤后海水浸泡具有显著疗效。
Objective To investigate a good therapeutic method of open chest injury coupled with seawater immersion. Methods Fifty-three patients with open chest injury coupled with seawater immersion were received combined modality therapy, including early first aid, surgical operation , to correct electrolyte imbalance and metabolic acidosis, resisting infection, rewamting, pentoxifylline （PTX） and so on. Changes of arterial blood gas, serum osmotic pressure, electrolyte and therapeutic effect were recorded and compared before and after treatment. Results The patients had hypothermia and acid-base imbalance before treatment. When the patients had been treated for 4 hours, pH value, carbon dioxide partial pressure, partial pressure of oxygen, plasma osmotic pressure approached norreal level and when for 8 hours, blood electrolytes reached normal level. Livability reached to 96% （51/53）. There were statistical differences in all indexes before and after treatment （P 〈 0.01 ）. Conclusion PTX may inhibit production of TNF-α, reduce pulmonary microvasctdar permeability and prevent from acute lung injury caused by open chest injury coupled with seawater immersion. Combined modality therapy can obviously improve open chest injury coupled with seawater immersion.
出处
《海军医学杂志》
2010年第4期296-299,共4页
Journal of Navy Medicine
基金
全军医学科学技术"十一五"课题(06MB174)
关键词
胸部开放伤
海水浸泡
急性肺损伤
Open chest injury
Seawater immersion
Acute lung injury
